About the START programme

Who is the START programme for, and why?

The START programme was developed for toddlers with a family connection to autism or ADHD because research indicates that they may benefit from additional support to promote the development of strong attention, regulation and thinking skills (known as executive functions). Strong executive functions are linked to better mental health and higher quality of life, across a range of populations.

Toddlers with a family connection of autism or ADHD are more likely than average to be later diagnosed with autism or ADHD. Some toddlers with a family connection of autism or ADHD will not meet the clinical cut-off levels for a diagnosis, but will still show higher autistic or ADHD traits. Autism and ADHD are both conditions that are associated with executive function difficulties in later childhood and adulthood, so supporting early executive development may help these toddlers to thrive in later life.

Many toddlers with a family connection of autism or ADHD will be neurotypical – that is they will not show any signs of a developmental condition. Supporting early executive development may still be beneficial for these toddlers as strong executive functions are associated with higher levels of health, wealth and happiness in typically-developing populations too.

What approach does the START programme take?

The aim of the START programme is to support all children to thrive, whether they are neurodivergent (i.e. autistic/ADHD) or neurotypical (have no developmental conditions). The programme training and materials place an emphasis on inclusivity and valuing neurodiversity. The programme is not about training children to perform neurotypical behaviours or reducing likelihood of a later diagnosis of autism or ADHD. The programme is also not designed to address specific developmental needs such as language delay, but can be used alongside clinical services or educational supports.

The START programme is based around parent-child play sessions, using songs, games and stories to provide enjoyable opportunities for toddlers’ skill development. The sessions will have a large element of parent-to-parent peer support and the session materials include insights provided by the parents involved in the programme development.

The START programme has been developed by Dr Alexandra Hendry, in collaboration with Peeple. Dr Hendry is a developmental psychologist at the University of Oxford. She specialises in understanding the development of early executive functions – the thinking and regulation skills that allow us to control our impulses, think flexibly to solve problems, and set and work towards goals.

Peeple are a charity whose main purpose is to support parents or carers, babies and children to learn together. Their evidence-based Learning Together Programme (https://www.peeple.org.uk/ltp) is a strengths-based approach to working with families, focusing on doing with rather than doing to parents. The Learning Together Programme provides the foundations for the START programme but the content has been specifically developed with the needs and interests of parents and toddlers with a family connection to autism or ADHD in mind.

What will happen in the START sessions?

Two specially-trained facilitators will lead the sessions each week. In the group discussion part of the session, one facilitator will share the topic and key information for the session, and encourage parents to share tips and ideas about the topic. The other facilitator is on hand to play with the toddlers whilst parents chat, but children can stay as close to their parent as they want.

In the activities part of the session, the facilitators will share out toys and suggest some ways of playing that are related to the session topic, and which may help toddlers to practise some important skills. Parents are encouraged to adapt the activity ideas to suit their child. Each session will end with some new and familiar songs, and the facilitator will share a story with the toddlers.

Each week you will be given some resources to take away, so that you can carry on trying and adapting the activity ideas at home. These will include a mixture of ideas sheets and toys.

Each session lasts an hour. There are 12 sessions in total, at the same time and location each week. There will be between 4 and 8 parents in a group, each with a child aged between 21 and 24 months (at the first session).

Where and when will the sessions be held?

The sessions will be held in family-friendly venues in Oxford and East London. The facilitator leading the sessions in your area will talk you through the options and ask you if you have any specific access needs.  They will also arrange a phone call with you to find out which times and days would most suit you, and explain how you can get your travel costs reimbursed.

Are the sessions just for parents?

The study is open to anyone who has parental responsibility or legal guardianship to an eligible toddler. We ask that whichever adult has enrolled in the study is the main person who attends the sessions. Any family member or carer who regularly looks after your child is welcome to come along with you to a session. You are also welcome to bring along another adult with you if it would make the session more accessible.

Do I need to go every week?

If you can, we’d love you to come every week during the 12-week period that your group sessions are running. But we know that life is busy and complicated so that might always not be possible, and we have built into the session plans time to go over important content that was missed.

Will you cover my travel expenses?

Yes. You will be able to claim up to £5 without a receipt, or £15 with a receipt, to cover travel or childcare costs associated with attending each START programme session.

Can I bring my other children?

The sessions themselves are just for toddlers and their parents, but if you have an older child it may be possible (depending on the venue, and their needs) for them to relax in a nearby room during the session. The practitioner leading the sessions will discuss this with you before the first session, to work out what is best. If it is not possible to bring your older child along, and you need to arrange for paid childcare for them instead, we will help to cover those costs (up to £15 per session).